title: Effect of the woman's age on discontinuation of IVF treatment.
abstract: Treatment discontinuations are an important issue in IVF programmes. In the French context, financial constraint does not intervene in discontinuation until older ages. This study examined treatment discontinuation in IVF programmes, according to the woman's age and when there is no financial burden for couples. Medical records were collected for 3037 women who began their IVF programme between 1998 and 2002 in two French IVF units. Up to four attempts were taken into consideration. Cumulative success (delivery) rates were calculated, as well as discontinuation rates. Multiple imputation was applied to estimate a theoretical cumulative success rate as if no woman discontinued treatment before the end of the IVF programme without delivering. Cumulative discontinuation rates at the end of the IVF programme increased with the woman's age (41% for age <35, 56% for age 35-39, 80% for age ⩾40). The benefit in terms of delivery rates of pursuing treatment would be smaller for older women (∼10% for age <35, 7% for age 35-39, 4% for age ⩾40). Even when treatment is reimbursed, the discontinuation rate is high for older women, suggesting that the strong decrease in success rate with age induces older women to discontinue. Treatment discontinuations are an important issue in IVF programmes. In the French context, financial constraint does not intervene in discontinuation until older ages. We aimed to examine treatment discontinuation in IVF programmes, according to the woman's age and when there is no financial burden for couples. Medical records were collected for 3037 women who began their IVF programme between 1998 and 2002 in two French IVF units. Up to four attempts were taken into consideration. Cumulative success (delivery) rates were calculated, as well as discontinuation rates. Multiple imputation was applied to estimate a theoretical cumulative success rate as if no woman discontinued treatment before the end of the IVF programme without delivering. Cumulative discontinuation rates at the end of the IVF programme increased with the woman's age (41% for age <35, 56% for age 35-39, 80% for age ⩾40). The benefit in terms of delivery rates of pursuing treatment would be smaller for older women (∼10% for age <35, 7% for age 35-39, 4% for age ⩾40). Even when treatment is reimbursed, the discontinuation rate is high for older women, suggesting that the strong decrease in success rate with age induces older women to discontinue.
authors.affiliation: INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Reproduction and Child Development Team, F-94276 Le Kremlin-Bicêtre, France; Université Paris-Sud 11, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France; INED, F-75020 Paris, France.
authors.forename: Noémie
authors.initials: N
authors.lastname: Soullier
authors.affiliation: INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Reproduction and Child Development Team, F-94276 Le Kremlin-Bicêtre, France; Université Paris-Sud 11, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France; INED, F-75020 Paris, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Bouyer
authors.affiliation: Unité de FIV, CHU de Clermont-Ferrand, F-63003 Clermont-Ferrand, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Pouly
authors.affiliation: Unité de Médecine de la Reproduction, Service de Gynécologie-Obstétrique II, Hôpital Cochin, F-75014 Paris, France; Laboratoire de Procréation Médicalement Assistée, Institut Mutualiste de Montsouris, F-75014 Paris, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Guibert
authors.affiliation: INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Reproduction and Child Development Team, F-94276 Le Kremlin-Bicêtre, France; Université Paris-Sud 11, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France; INED, F-75020 Paris, France.
authors.forename: Elise
authors.initials: E
authors.lastname: de La Rochebrochard
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D005307:Fertilization in Vitro / Q000523:psychology*; D006801:Humans; D008423:Maternal Age; D010352:Patient Dropouts / Q000523:psychology*; D016896:Treatment Outcome